<!DOCTYPE html>
<html class="panel-fit"><head>
	<meta charset="UTF-8">
	<title>云his工作平台</title>
    <link rel="stylesheet" type="text/css" href="/static/easyui/css/bootstrap/easyui.css">
    <script type="text/javascript" src="/static/jquery/jquery-1.11.3.min.js"></script>
    <script type="text/javascript" src="/static/js/head.js"></script>
</head>

<body>

<div class="inp-form">
    <form id="fm" method="post">
        <div class="fitem">
            <label>
                临床诊断：
            </label>
            <input title="" name="AccountCode" class="easyui-validatebox validatebox-text validatebox-invalid" required="true">
        </div>
        <div class="fitem">
            <label>
                检验科室：
            </label>
            <input title="" name="AccountName" class="easyui-validatebox validatebox-text validatebox-invalid" required="true">
        </div>	       
        <div class="fitem">
            <label>
                类别：
            </label>
             <input title="" name="AccountName" class="easyui-validatebox validatebox-text validatebox-invalid" required="true">
        </div>
        <div class="fitem">
            <label>
                标本：
            </label>
            <input title="" name="AccountName" class="easyui-validatebox validatebox-text validatebox-invalid" required="true">
        </div>
        <div class="fitem">
            <label>
                标本说明：
            </label>
			<textarea class="easyui-validatebox validatebox-text validatebox-textarea"></textarea>           
        </div>
        <div class="fitem">
            <label>
                送检医师：
            </label>
            <input title="" name="AccountName" class="easyui-validatebox validatebox-text validatebox-invalid" required="true">
        </div>
        <div class="fitem">
            <label>
                申请时间：
            </label>
            <input style="display: none;" class="easyui-datebox datebox-f combo-f textbox-f"><span style="width: 260px; height: 22px;" class="textbox combo datebox"><span style="right: 0px;" class="textbox-addon textbox-addon-right"><a style="width: 18px; height: 20px;" href="javascript:void(0)" class="textbox-icon combo-arrow" icon-index="0" tabindex="-1"></a></span><input style="margin-left: 0px; margin-right: 18px; padding-top: 0px; padding-bottom: 0px; height: 20px; line-height: 20px; width: 240px;" placeholder="" class="textbox-text validatebox-text textbox-prompt" autocomplete="off" type="text"><input value="" name="" class="textbox-value" type="hidden"></span>
        </div>
        <div>
			<table cellpadding="0" cellspacing="0" width="100%" class="tab-autoline">
				<thead>
					<tr>
						<Th><input type="checkbox"></th>
						<th>项目名称</th>
						<th>项目子项</th>
						<th>估计金额</th>
						<th>操作</th>
					</tr>

				</thead>
				<tbody>
					<tr>
						<Td><input type="checkbox"></td>
						<td><select class="nonbor-inp" style="width:200px;"/><option>请选择</option><option>凝血六项</option></select></td>
						<td class="text-left padd-5">
							1.凝血一项&nbsp;&nbsp;
							2.凝血二项&nbsp;&nbsp;
							3.凝血三项&nbsp;&nbsp;
							4.凝血四项&nbsp;&nbsp;
							3.凝血五项&nbsp;&nbsp;
							3.凝血六项&nbsp;&nbsp;
						</td>
						<td>20.0</td>
						<td><a >删除</a></td>
					</tr>
					
				</tbody>
			</table>
			<div class="tab-bbtn">
				<button class="easy-nbtn easy-nbtn-info">添加</button>
				<button class="easy-nbtn easy-nbtn-warning">删除</button>
			</div>

		</div>
        <div class="form-btn">
            <button class="save-btn">保&nbsp;存</button>
			&nbsp;&nbsp;<a >直接发送</a>
        </div>
    </form>
</div>

<div class="inp-tab">
	<div class="margb-10">
		<table cellpadding="0" cellspacing="0" width="100%">
			<tr>
				<td class="text-right">申请日期：</td>
				<td><input type="text" class="validatebox-text vt-text-percent"/></td>
				<td class="text-right">检验项目名称：</td>
				<td><input type="text" class="validatebox-text vt-text-percent"/></td>
			</tr>
			<tr>
				<td class="text-right">检验科室：</td>
				<td><input type="text" class="validatebox-text vt-text-percent"/></td>
				<td class="text-right">标本：</td>
				<td><input type="text" class="validatebox-text vt-text-percent"/></td>
			</tr>
			<tr>
				<td class="text-right">结果状态：</td>
				<td><input type="text" class="validatebox-text vt-text-percent"/></td>
				<td>
					<button class="easy-nbtn easy-nbtn-info">查询</button>
				</td>
				<td class="fd-right" style="padding-top:5px; padding-right:5px;">
					<button class="easy-nbtn easy-nbtn-success">发送</button>
				</td>
				
			</tr>
			
		</table>	
		
	</div>
    <table cellpadding="0" cellspacing="0" width="100%" class="tab-rlist">
        <thead>
		 <tr>
				<Th><input type="checkbox"></th>
				<th>申请日期</th>
				<th>标本</th>
				<th>检验项目名称</th>
				<th>检验科室</th>
				<th>结果状态</th>
				<th>操作</th>
			</tr>
        </thead>
        <tbody>
			<tr>
				<Td><input type="checkbox"></td>
				<td>2015.12.15</td>
				<td>皮肤</td>
				<td class="text-left padd-5">
					<a >1.寄生虫镜检</a><br/>
					<a >2.凝血六项</a><br/>
					<a >3.血细胞分析+五分类</a>
				</td>
				<td>皮肤科</td>
				<td>新增项</td>
				<td><a >发送</a>&nbsp;&nbsp;<a >删除</a></td>
			</tr>
			<tr>
				<Td><input type="checkbox"></td>
				<td>2015.12.15</td>
				<td>皮肤</td>
				<td class="text-left padd-5">
					<a >1.寄生虫镜检</a><br/>
					<a >2.凝血六项</a><br/>
					<a >3.血细胞分析+五分类</a>
				</td>
				<td>皮肤科</td>
				<td>已出结果</td>
				<td><a >查看</a></td>
			</tr>

        </tbody>

    </table>

</div>

</body>


</html>